Information Collection

Survey#3 Disadvantaged Business Enterprise (DBE) Status Verification

IC 237102 under ICR 202107-2130-003 · OMB 2130-0631.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form FRA F 6180.174 Survey#3 Disadvantaged Business Enterprise (DBE) Status Verification	Form
FRA F 6180.174 Survey#3 Disadvantaged Business Enterprise (DBE) Status Form FRA F 6180.174.doc	Form
FRA F 6180.174 Survey#3 Disadvantaged Business Enterprise (DBE) Status Form FRA F 6180.174.doc	Form

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Unchanged

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	FRA F 6180.174	Survey#3 Disadvantaged Business Enterprise (DBE) Status Verification	Form FRA F 6180.174.doc		Yes	No	Paper Only

Line of Business: Transportation

Subfunction: Ground Transportation

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 35,000

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	4,250	4,250
Annual IC Time Burden (Hours)	213	213
Annual IC Cost Burden (Dollars)	12,251	12,251

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.